People of African, Asian, Latin and Native American backgrounds know that their skin, hair and nails are subject to conditions that do not affect lighter skinned people. “While most of these are not serious, they may be disturbing, troubling or unsightly,” says Joshua Fox, MD, a leading dermatologist, founder of Advanced Dermatology and an official spokesperson for the American Academy of Dermatology and the American Society of Dermatologic Surgery.
“Fortunately, your dermatologist is well acquainted with these conditions and can help people with dark skin to diagnose and treat their concerns early and quickly,” says Dr. Fox. He offers the following listing of the top skin conditions faced by people of color and how it differs from lighter-skinned individuals.
1. Acne – Many dark skinned women suffer from acne vulgaris, sometimes combined with hyper pigmentation, or skin darkening in spots or patches, which occurs in response to the outbreak of acne. Unlike fairer-skinned individuals, the discoloration plays an integral role in treatment. Surprisingly, these patients are more bothered by the discoloration than the acne itself. Treatments may include topical skin lightening creams for dark spots, sunscreen and topical, prescription acne medications.
2. Dermatosis Papulosa Nigra – These brown or black raised spots, which commonly affect African American women and people of Asian descent, may look like moles or flattened warts. They are always benign, never lead to skin cancer and are not harmful. However, some people do have them removed for cosmetic reasons. Typically, up to 50 percent of Dermatosis Papulosa Nigra patients have a family history of the condition, and up to 35 percent of adult blacks in the United States have it. They are easily removed with minimal to no marks.
3. Eczema – Very common among those with brown skin, eczema is an itchy, irritating rash that can occur in skin of any type or color. However, according to the National Eczema Society, it is found twice as often in black skin. When it does occur, differences in the structure of black from Caucasian skin can cause related problems including excessive pigmentation and a thickening of the skin that can also cause changes in skin color. “Because eczema is harder to identify in dark skin, and is often confused with psoriasis or fungal infections, getting the right diagnosis and treatment can be difficult,” Dr. Fox says. “Once the correct diagnosis has been made, topical medicines are quite helpful.”
4. Keloids – Scar tissue caused by abnormal healing of the skin occurs frequently in individuals with brown skin. Any time dark skin is injured, the risk of keloids is dramatically increased. According to Skin & Aging magazine, up to 16% of black and Asian people suffer from keloids. Keloids can develop immediately following an injury or take a long time to grow. Sometimes they itch, are painful and burning or feel tender to the touch. Treatments include cortisone and other injections, radiation therapy, pressure dressings, silicone gel applications and several types of lasers are extremely helpful. Keloids can also be removed via traditional or laser surgery.
5. Traction Alopecia – This hair loss condition is caused by damage to the hair follicle from constant pulling or tension over a long period of time. It is most common in African Americans who braid their hair tightly, but can also be caused by over processing of the hair through dyes, bleaches or straighteners. According to the National Institutes of Health, some 17% of African-American schoolgirls (6-21 years) and more than 30% of women (18-86 years) suffer from traction alopecia. While this condition can be reversed if diagnosed early, it can lead to permanent hair loss if it is undetected for a long period. These people – mainly women – should change to looser, gentler hair styles and should see a dermatologist. Unfortunately, no medical treatment is available to reverse late-stage traction alopecia; hair grafts, transplants or wigs have been identified as the only practical solution.
6. Melanoma — Those with brown skin often have a false sense of security when it comes to skin cancer. “While increased skin pigmentation offers some protection against the sun’s harmful UV rays,” Dr. Fox says, “melanoma can and does occur,” unlike in the lighter-skinned individual, it occurs especially on the palms, soles, fingers and toes, nails and mucous membranes (such as the mouth or nose). “A new dark mark or a mark that changes in size, shape or color in these areas should be seen by a dermatologist immediately. Even people with dark skin should always use a sunscreen when spending extensive time in the sun,” he says.
7. Pigmentation – Women with brown skin, particularly those of African and Latino descent, have a high incidence of hypertension, diabetes and heart disease and thus take medications for those medical problems. These, as well as other commonly used medications (LIST MEDICATIONS THAT CAN CAUSE PROBLEMS) can cause various types of allergic reactions that frequently lead to hyperpigmentation, or dark patches. While the dark spots can fade over time, women should seek treatment early. Procedures such as chemical peels and skin bleaching, designed to lighten the darkened areas, can help, as can diligent use of sunscreen. The new Fraxel™ is the first laser approved for treatment of melasma – a type of pigmentation disorder of the face.
8. Vitiligo – Skin gets its color from pigment cells. When those cells are damaged or destroyed, they no longer produce pigment, causing white or colorless spots to appear. The spots can grow larger over time and eventually blend together so that large portions of the skin have no color at all. While no one knows why this occurs, many suspect it is related to problems within the autoimmune system. Vitiligo also may be hereditary. While people of any skin color can develop Vitiligo, it is most obvious and therefore debilitating on dark skin. One common treatment is PUVA — a repigmentation therapy involving the drug psoralen combined with exposure to UV light. A simpler, newer and equally efficacious treatment is narrowband UVB light treatment. The newest laser treatment though is that of the Excimer laser 308nm which markedly shortens the number to treatments and spares unwanted streaks. This process help increase the amount of pigment cells at the skin’s surface. Other treatments include prescription-strength corticosteroid cream, light/laser treatments and, in rare instances, skin grafting.
Medical tourism is a growing trend when it comes to plastic and cosmetic surgery. Some Americans believe that they can get the same cosmetic procedures for a lower cost outside the U.S.
Brazil, Chile, Venezuela and Colombia are the most popular destinations among American medical tourists. An interesting fact: some of the better surgeons were actually trained in Cuba. There are a lot of excellent doctors in Latin America and the equipment they use is often comparable to that available in the laser clinics in the U.S. You just have to do your own research to avoid complications.
Importance needs to be placed on researching the doctor’s credentials and experience because you want a doctor who is qualified and will take good care of you. As far as the cost… These days you can get excellent deals within a reasonable driving distance from your home. Plastic surgeons and medical spas in the U.S. is a very saturated business. There is a lot of competition and a lot of top notch experts in both surgical and non-invasive procedures. Give them a chance at a free consult before you board an airplane! Guess where the Swiss are going to save money on cosmetic surgery? The U.S.!
This is a good video report, which covers most of the things a consumer should know about tattoo removal by a medical laser. Join Neil Sadick, MD, as he performs laser tattoo removal and provides tips for what to expect from the procedure.
Laser Tattoo Removal
(opens in new window)
Some people wonder why OB/GYN practices offer LHR. Isn’t it the realm of plastic surgeons and dermatologists?
For gynecologists laser hair removal is a natural transition and a perfect fit as they can perform these procedures in discrete areas of the female body in a comfortable setting of a medical office. Permanent reduction of hair in women care clinics also tends to be more affordable as these treatments are typically focused on small areas and can be combined with regular office visits.
Highly controlled flashes of laser beams are selectively absorbed by hair follicles lying below the surface of the skin. The absorbed light heats the hair, which damages and destroys the regrowth potential of the follicle- all without damaging surrounding tissue. Hair follicles are usually in different growth cycles at different times in relation to one another. Since the follicle must in active growth in order to be affected by the laser, several treatments spread over several months are required to assure the destruction of all hair follicles.
Areas treated: bikini area, underarms, and face.
We stumbled upon an old (March 7, 2007) article in ABC News – Spa Left Woman With Skin ‘Like Raw Meat’ – a story about a 52-year-old stay-at-home mom who saw the ugly side of medical spas. She went to one in Panama City, Fla., for what she thought was a routine procedure – laser treatments to remove sunspots on her back and chest.
“They put a topical ointment on my skin called Leveline, which intensified the laser,” Miles said. “After it was over, I was already burning. During the treatment, it was very excruciating pain, but I was lead to believe that this was normal.”
The pain, which she said felt like someone pressing hot curling irons in to her back, was not normal. After leaving the spa, she said that her back was on fire and that she was vomiting from the severe pain. When she finally looked in a mirror, Miles was shocked at what she saw.
“It looked like raw meat. I had horrendous blisters all over it. It was in a zebra-stripe type pattern. It was scary,” she said.
Why the newer fractional technologies are so popular?
The latest fractional laser technologies offer a better balance of efficacy, patient tolerance and lack of side effects compared to older lasers.
For better results the depth of the laser beam penetration and the depth of skin resurfacing are important. But even more important is an optimal combination of depth, microspot size, density, as well as the ratio of ablation to coagulation.
Depth is a simple term that indicates how deep the thermal damage extends into the skin tissue. It is the depth of the microcrater or hot cylinder.
Microspot size is the diameter of the microscopic wound.
Density is the percent coverage over the skin surface, e.g. 20 percent density means 20 percent of the skin surface is damaged.
The “ratio of ablation to coagulation” can be explained as follows: one pulse of laser beam produces a crater (coagulation area), which is 100 µm wide, and the lateral thermal damage (area of ablation) of 50 µm in radius (100 µm in diameter) ; therefore in this case, the total width of coagulation is 100 µm, and the total width of ablation is 100 µm, therefore 1:1. This ratio is an indication of the downtime. Coagulation is a type of thermal damage, which greatly influences wound healing.
The problem is that no one knows the precise best recipe among all of these variables to achieve the best ratio of cosmetic enhancement to days of “downtime.”
1. It’s your body’s largest organ: an average adult’s skin spans 21 square feet, weighs 9 pounds and contains more than 11 miles of blood vessels.
2. The skin releases as much as 3 gallons of sweat a day in hot weather. The areas that don’t sweat are the nail bed, the margins of the lips, the tip of the penis and the eardrums.
3. Body odor comes from a second kind of sweat – a fatty secretion produced by the apocrine sweat glands, found mostly around the armpits, genitals and anus. The odor is caused by bacteria on the skin eating and digesting those fatty compounds.
4. Fetuses don’t develop fingerprints until three months of gestation (the period during which an embryo develops (about 266 days in humans)). Some people never develop fingerprints at all. Two rare genetic defects, known as Naegeli syndrome and dermatopathia pigmentosa reticularis, can leave carriers without any identifying ridges on their skin.
5. Globally, dead skin accounts for about a billion tons of dust in the atmosphere. Your skin sheds 50,000 cells every minute.
6. There are at least five types of receptors in the skin that respond to pain and to touch. One experiment revealed that Meissner’s corpuscles – touch receptors that are concentrated in the fingertips and palms, lips and tongue, nipples, penis and clitoris – respond to a pressure of just 20 milligrams, the weight of a fly. In blind people, the brain’s visual cortex is rewired to respond to stimuli received through touch and hearing, so they literally “see” the world by touch and sound.
7. “In the buff” became synonymous for “nude” in 17th-century England. The term derives from soldiers’ leather tunics, or “buffs,” whose light brown color apparently resembled an Anglo-Saxon backside.
8. White skin appeared just 20,000 to 50,000 years ago, as dark-skinned humans migrated to colder climes and lost much of their melanin pigment.
9. The Cleveland Public Library, Harvard Law School and Brown University all have books clad in skin stripped from executed criminals or from the poor. Hopefully, they didn’t have to reprint it: One such volume is Andreas Vesalius’s pioneering 16th-century work of anatomy, “De Humani Corporis Fabrica” (On the Fabric of the Human Body).